Telemedicine vs. In-person Preoperative Appointments in Elective Orthopaedic Surgery
Introduction: In orthopaedics, telemedicine has been successfully integrated into postoperative evaluations and rehabilitation. Due to the COVID-19 pandemic, there has been a shift towards increased utilization of telemedicine. However, telemedicine has not been studied as a substitute for in-person preoperative consultations. The purpose of this study was to compare patient satisfaction for patients who experienced in-person versus telemedical preoperative orthopaedic visits.
Methods: A retrospective review was performed for patients ≥18 years who underwent joint or spine surgery between March 2020 and December 2020 at a single institution. Due to the pandemic, patients had the option of in-person or strictly telemedical preoperative consultation. Online satisfaction questionnaires were distributed through REDCap subsequent to their surgery. Patients were grouped as in-person or telemedicine, and groups were compared via independent t-tests for continuous variables and chi-square tests for categorical variables. Alpha was set at 0.05.
Results: Of the 174 responses, 104 were in-person (29.1% response rate) and 70 were telemedicine (44.0% response rate). Patients with in-person appointments more frequently took time off of work for their appointment (33.7% vs. 4.48%, p<0.001) but experienced less barriers to communication (3.85% vs. 27.5%, p<0.001). The in-person group had higher preoperative appointment satisfaction rates but also higher rates of dissatisfaction (81.7% vs. 70.0% and 15.4% vs. 12.9%, p=0.005). Patient satisfaction with their surgery (78.8% vs. 84.3%, p=0.715) and patient satisfaction with their surgeon (80.6% vs. 85.7%, p=0.248) were not significantly different between groups. Patients who conducted their appointment in-person were more likely to prefer to keep their appointment format the same (91.3% vs. 68.6%, p<0.001).
Discussion: The pandemic has resulted in significant changes to surgical workflow. The results of this study demonstrate no differences in patient satisfaction rates between telemedicine and in-person preoperative consultations. Future investigation is required to determine whether telemedical consultation is a viable workflow extending beyond the pandemic.
Level of Evidence: III (retrospective cohort study)
Keywords: telemedicine, preoperative care, patient satisfaction, patient preferences, digital health, telehealth
Citation: Karamian BA, Toci GR, Mao JZ, Ju DG, Canseco JA, Lambrechts MJ, Hameed D, Grewal L, Kaye ID, Hilibrand AS, Kepler CK, Krueger CA, Hozack WJ, Vaccaro AR, Schroeder GD. “Telemedicine vs. In-person Preoperative Appointments in Elective Orthopaedic Surgery”. SVOA Orthopaedics 1:2 (2021) Pages 48-53.